Pathological characterisation of male breast cancer: Results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program
Vermeulen, Marijn A; Slaets, Leen; Cardoso, Fatima; Giordano, Sharon H; Tryfonidis, Konstantinos; van Diest, Paul J; Dijkstra, Nizet H; Schröder, Carolien P; van Asperen, Christi J; Linderholm, Barbro; Benstead, Kim; Foekens, Renee; Martens, John W M; Bartlett, John M S; van Deurzen, Carolien H M
(2017) European Journal of Cancer, volume 82, pp. 219 - 227
(Article)
Abstract
AIM: Several prognostic histological features have been established in female breast cancer (BC), but it is unknown whether these can be extrapolated to male BC patients. The aim of this study was to evaluate the prognostic value of several histological features in a large series of male BC. METHODS: Central
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pathology review was performed for 1483 male BCs collected through part 1 of the European Organisation for Research and Treatment of Cancer (EORTC) International Male BC Program. Pathology review included histological subtype, grade, mitotic activity index (MAI), presence of a fibrotic focus and density of tumour-infiltrating lymphocytes (TILs). These features were correlated with clinical outcome. The relationship between these features and surrogate molecular subtypes using immunohistochemistry was also assessed. RESULTS: Median follow-up for overall survival (OS) was 7.1 years. Overall histological grade was not significantly associated with OS (p = 0.129). MAI, the presence of a fibrotic focus and a low TIL density however were correlated with unfavourable OS (p = 0.023, p = 0.004 and p = 0.011, respectively). BC subtype correlated with TIL density (p = 0.015), as we observed a higher density for human epidermal growth factor receptor type 2 (HER2) positive BC compared to luminal HER2-negative subtype. No association was observed between subtype and fibrotic focus. CONCLUSIONS: Histologic grade was not significantly correlated with clinical outcome in this series, unlike what is seen in female patients. These results contribute to our understanding of male BC and indicate the importance of further research on the optimisation of risk stratification and treatment decisions for male BC patients.
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Keywords: Aged, Biomarkers, Tumor, Breast Neoplasms, Male, Carcinoma, Carcinoma, Ductal, Breast, Carcinoma, Lobular, Fibrosis, Humans, Immunohistochemistry, Lymphocytes, Tumor-Infiltrating, Male, Middle Aged, Mitotic Index, Prognosis, Survival Analysis, Journal Article, Research Support, Non-U.S. Gov't, Oncology, Cancer Research, Journal Article
ISSN: 0959-8049
Publisher: Elsevier Limited
Note: Funding Information: We are grateful to all patients, investigators and pathologists who participated in the study, to all national coordinating centres and groups (EORTC-Breast Cancer Group, BOOG, SABO, ICORG, SAKK, PALGA), their centres and to many independent sites from USA, UK and Spain, to TBCRC and to BIG. The International Male Breast Cancer Program and this work is supported by grants from the Breast Cancer Research Foundation, the Dutch Pink Ribbon, the European Breast Cancer Council, the Susan G. Komen for the Cure, the Swedish Breast Cancer Association and the Erasmus MC Cancer Institute. This publication was supported by Fonds Cancer (FOCA) from Belgium. The authors thank the registration of the Comprehensive Cancer centres for the collection of data for the Netherlands Cancer Registry and the scientific staff of the Netherlands Cancer Registry. Publisher Copyright: © 2017 Elsevier Ltd
(Peer reviewed)